Development of a questionnaire for the assessment of bronchial hyperresponsiveness

Abstract

Bronchial hyperresponsiveness (BHR) is a hallmark of asthma. Treatment approaches based on BHR severity have been shown to be effective. However, challenge tests are expensive, inconvenient to patients, time consuming, and not easily accessible to general practitioners. Assessment of BHR by a questionnaire would be advantageous in the diagnosis and management of asthma. To select a set of respiratory symptoms and provoking stimuli related to BHR to compose a reliable Bronchial Hyperresponsiveness Questionnaire (BHQ). A list of 33 symptoms and 68 stimuli were selected by in-depth interviews, focus group discussions with asthma patients, and literature review. After a histamine challenge test patients (n=302) were asked to score each question on a 7-point scale (0=no; 6=severe complaints). Factor analysis was performed to identify clusters of interrelated symptoms associated with PC20-histamine. The sensitivity to detect the presence of BHR was analysed by Receiver Operating Curves (ROC). The correlation between the PC20-score and the scores on the questions was analysed. 15 symptoms and 19 provoking stimuli were ultimately selected for the BHQ. The BHQ was developed according to FDA-approved standards and is a condition-specific questionnaire able to assess the presence of BHR.